Billing code 53430: Urethral repairMedicare rate & RVUs in Texas
Reconstructive surgery on the female urethra, reported for a repair that rebuilds the urethral channel rather than a limited revision.
CMS doesn’t publish an office rate for 53430 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 53430 covers
This operation rebuilds the female urethra to restore a usable channel, such as when a stricture or structural defect requires reconstructive repair. A urologist or female pelvic medicine and reconstructive surgeon typically performs it in an operating room, using an approach suited to the location and extent of the urethral problem. The operative report should identify the defect and describe the reconstruction performed.
Report this code for female urethral reconstruction; use a neighboring code when the operative work instead includes bladder neck reconstruction or addresses a different urethral anatomy or procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this single urethral reconstruction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 53430 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $877.94 |
| Beaumont | Unavailable | $847.14 |
| Brazoria | Unavailable | $857.69 |
| Dallas | Unavailable | $865.74 |
| Fort Worth | Unavailable | $864.56 |
| Galveston | Unavailable | $862.05 |
| Houston | Unavailable | $906.71 |
| Rest Of Texas | Unavailable | $853.76 |
How the 53430 rate is calculated
Each of 53430’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 53430
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.99Practice expense 6.71Malpractice 2.44
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53430
53430 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53430
Urethral repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53430
Urethral repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53430 without 51 · national facility
$873.10
Urethral repair
53430-51 · Second procedure: 50%
$436.55
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
53430 compared with similar codes
Compare codes
53430 vs 53431 vs 53410 vs 53415 vs 53450: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53431Urethral reconstruction
- Choose 53431 when the female urethral reconstruction also includes bladder neck reconstruction. Use 53430 for reconstruction of the female urethra without that additional bladder neck work.
- 53410Urethral reconstruction
- 53410 describes one-stage reconstruction of the male anterior urethra; 53430 is for female urethral reconstruction.
- 53415Urethroplasty
- 53415 addresses one-stage reconstruction of the male prostatic or membranous urethra, rather than reconstruction of the female urethra.
- 53450Urethral revision
- 53450 is for revision of the urethra. Choose 53430 when the operative work is reconstructive rebuilding of the female urethra rather than a revision procedure.
53430 billing questions
When is 53431 used instead?
Use 53431 when the operation reconstructs the female urethra and also reconstructs the bladder neck. The operative report should support that additional bladder neck work.
How does 53430 differ from male urethroplasty codes?
53430 is for reconstruction of the female urethra. Codes such as 53410 and 53415 describe reconstruction involving male urethral anatomy.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this reconstruction of the female urethra.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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